BACKGROUND: The Helicobacter pylori(H. pylori) is associated with chronic gastritis and is now recognized to be the main factor in the pathogenesis of peptic ulcer disease. The eradication treatment of H. pylori significantly lowers ulcer relapse rate, which is accompanied by important histological change. We evaluated the prevalence of H. pylori infection in upper gastrointestinal diseases. METHODS: Total 491 patients(274 with chronic gastritis, 134 with gastric ulcer, 57 with duodenal ulcer, and 26 with gastroduodenal ulcer) were tested for H. pylori infection by the CLO test, hematoxylin-eosin stain and Giemsa stain. RESULTS: The prevalence of H. pylori infection was 74.0% in male and 58.6% in female. The prevalence of H. pylori infection was 73.2% in 30-59 year-old group and 60.2% in older age group. The sex and age adjusted prevalence of H. pylori infection was 64.7% in chronic gastritis, 69.4% in gastric ulcer, 84.5% in duodenal ulcer and 87.8% in gastroduodenal ulcer. CONCLUSIONS: The prevalence of H. pylori infection of upper gastrointestinal diseases is significantly higher in male, 30-59 year-old group, peptic ulcer and duodenal ulcer than in female, older age group(over 60), chronic gastritis and gastric ulcer, respectively.
Azure Stains ; Duodenal Ulcer ; Female ; Gastritis ; Gastrointestinal Diseases* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Peptic Ulcer ; Prevalence* ; Recurrence ; Stomach Ulcer ; Ulcer

Conventional methods for stabilization of unstable cervical spines caused by flexion injury are sublaminar wiring and palte and screw fixation. These methods, however, carry the risk of damage to the cervical cord and or vertebral artery. We have used interlaminar clamps for the stabilization of sixteen cases of unstable cervical spine, including for cases of odontoid process fracture. There was suecessful fusion in all cases, no slippage of clamp and no deterioration of neurological function. Advantages of this method include the fact the there is no need for bone graft and that it is technically easy and inexpensive. Good stabilization allows early ambulation and so prevents complications such as pneumonia and decubitus ulcer.
Early Ambulation ; Odontoid Process ; Pneumonia ; Pressure Ulcer ; Spine* ; Transplants ; Vertebral Artery

BACKGROUND: Postprimary pulmonary tuberculosis is located mainly in upper lobes. The tuberculous lesion involving the lower lobes usually arises from the upper lobe cavity through endobronchial spread. When tuberculosis is confined to the lower lung field, it often masquerades as pneumonia, lung cancer, bronchiectasis, or lung ahscess. Thus the correct diagnosis may be sometimes delayed for a long time. METHODS: We carried out, retrospectively, a clinical study on 50 patients confirmed with lower lung field tuberculosis who visited the Department of Pulmonary Medicine at Hanyang University Hospital from January 1992 to December 1994. The following results were obtained. RESULTS: Lower lung field tuberculosis without concomitant upper lobe disease occurred in fifty patients representing 6.9% of the total admission with active pulmonary tuberculosis over a period of 3 years. It occurred most frequently in the third decade but age distribution was relatively even. The mean age was 43 years old. Female was more frequently affected than male (male to female ratio 1:1.9). The most common symptom was cough(68%), followed by sputum(52%), fever(38%), and chest discomfort(30%). On chest X-ray of the S0patients, consolidation was the most common finding in 52%, followed by solitary nodule(22%), collapse(16%), cavitary lesion(l0%), in decreasing order. The disease confined to the right side in 25 cases, left side 20 cases, and both sides 5 cases. Endobronchial tuberculosis (1) Endobronchial involvement was proved by bronchoscopic examination in 20 of S0patients. (2) Mean age was 44years old and female was more affected than man (male to female ratio 1 : 3). Sputum AFB stain and Mycobacterium tuberculosis culture were positive only in 50% of cases unlikely upper lobe tuberculosis, additional diagnostic methods were needed. In our study, bronchoscopic examination and percutaneous fine needle aspiration biopsy increased diagnostic yield by 18% and 32%, respectively. The most common associated condition was diabetes mellitus(18%) and others were anemia, anorexia nervosa, stomach cancer, and systemic steroid usage. CONCLUSION: When we find a lower lung field lesion, we should suspect tuberculosis if the patient has diabetes mellitus, anemia, systemic steroid usage, malignancy or other immune suppressed states. Because diagnostic yield of sputum AFB smear & Mycobacterium tuberculosis culture was low, additional diagnostic methods such as bronchoscopy and fine needle aspiration biopsy were needed.
Adult ; Age Distribution ; Anemia ; Anorexia Nervosa ; Biopsy ; Biopsy, Fine-Needle ; Bronchiectasis ; Bronchoscopy ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Lung Neoplasms ; Lung* ; Male ; Mycobacterium tuberculosis ; Pneumonia ; Pulmonary Medicine ; Retrospective Studies ; Sputum ; Stomach Neoplasms ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

The purpose of the present study was to determine the preventive effects of combined interventional trial of fish oil treatment and exercise training on insulin resistance of skeletal muscle in high-fat fed rats. Male Wistar rats were randomly divided into chow diet (CD), high-fat diet (HF), high-fat diet with fish oil (FO), high-fat diet with exercise training (EX), and FO+EX groups. The rats in control group were fed chow diet containing, as percents of calories, 58.9% carbohydrate, 12.4% fat, and 28.7% protein. High-fat diet provided 32% energy as lard, 18% as corn oil, 27% as carbohydrate and 23% as casein. The fish oil diet had the same composition as the high fat diet except that 100 g menhaden oil was substituted for corn oil. Insulin sensitivity was assessed by in vitro glucose transport in the soleus muscle after diet treatment and treadmill running for 4 weeks. While the FO or EX only partially prevented insulin resistance on glucose transport and visceral obesity induced by high-fat diet, these interventions completely corrected hyperinsulinemia and hyperglycemia from the high-fat diet. The rats in the FO+EX showed normalized insulin action on glucose transport, plasma chemicals and visceral fat mass. Insulin-mediated glucose transport was negatively associated with total visceral fat mass (r=-0.734; p<0.000), plasma triglyceride (r=-0.403; p<0.05) and lepin (r=-0.583; p<0.001) concentrations with significance. Multiple stepwise regression analysis showed that only total visceral fat mass was independently associated with insulin-mediated glucose transport (r=-0.668; p<0.000). In conclusion, combined interventional trial of FO+EX recovered insulin resistance on glucose transport of skeletal muscle induced by high-fat diet. Visceral fat mass might be more important factor than plasma TG and leptin to induce insulin resistance on glucose transport of skeletal muscle in high-fat fed rats.
Animals ; Caseins ; Corn Oil ; Diet ; Diet, High-Fat* ; Glucose* ; Humans ; Hyperglycemia ; Hyperinsulinism ; Insulin Resistance ; Insulin* ; Intra-Abdominal Fat ; Leptin ; Male ; Muscle, Skeletal* ; Obesity, Abdominal ; Plasma ; Rats* ; Rats, Wistar ; Running ; Triglycerides

BACKGROUND: The most important acute complication of percutaneous transluminal coronary angioplasty (PTCA) is abrupt closure by dissection and thrombus, which account for the majority of deaths and emergency coronary artery bypass procedures associated with PTCA. We sought to determine the relationship between clinical, angiographic characteristics and abrupt thrombotic closure related to coronary intervention. METHODS: One hundred thirty two patients (61.6+/-8.0 year, 98 male) underwent PTCA or stenting under the diagnosis of acute myocardial infarction were analyzed at Chonnam University Hospital between Jan '97 and Jun '98. Patients were divided into two groups, one, 14 patients (Group A, 61.7+/-8.0 year, 9 male), who developed thrombotic occlusion, and the other, 118 patients (Group B, 61.5+/-8.0 year, 89 male) who did not develop abrupt closure related to the coronary intervention. RESULT: There were no significant differences in age, sex, risk factors, activated partial thromboplastin time, fibrinogen, erythrocyte sedimentation rate, C-reactive protein, location of lesion, branch involvement, lesion severity, AHA/ACC morphology between two groups. The incidence of intra-coronary thrombus was greater in Group A than in Group B (44% vs. 2%, p=0.025). Acute thrombotic occlusion related to the coronary interventions developed more frequently in the lesions within two days after the symptomatic onset (55% vs. 19%, p=0.035) and in the right coronary artery (RCA) lesions (55% vs. 24%, p=0.041). CONCLUSION: Predictors of abrupt thrombotic occlusion during coronary intervention in patients with acute myocardial infarction are intracoronary thrombus, earlier intervenion within 2 days after onset of aucte myocardial infarction and RCA lesion.
Angioplasty, Balloon, Coronary ; Blood Sedimentation ; C-Reactive Protein ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Emergencies ; Fibrinogen ; Humans ; Incidence ; Jeollanam-do ; Myocardial Infarction* ; Partial Thromboplastin Time ; Risk Factors ; Stents ; Thrombosis

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking

Bone and joint involvement develops in approximately 10 percent of patients with tuberculosis and half of these affected patients have tuberculosis of the spine. In the treatment of tuberculous spondylitis evacuation of the contents of the abscess, including the bone sequestra and the sequestrated intervertebral discs, combined with removal of all avascular bone and anterior fusion with a strut graft has widely applied since Hodgson and Stock published their successful results in 1960. Surgical approaches to the vertebral bodies at different levels, either anterior, anterolateral or modified approach, have been described in order to improve the exposure. The upper lumbar vertebral lesion is well exposed by the lateral or anterolateral approaches. But exposure of the lumbosacral lesion is limited because of iliac bone and other surrounding vital organs. We describe a surgical approach to lumbosacral spine which allows an adequate exposure of the vertebral bodies from L4 to S1. The transabodminal midline approach seems to be useful method for the lumbosacral vertebral body lesion, allows adequate exposure and easy reconstruction.
Abscess ; Humans ; Intervertebral Disc ; Joints ; Spine ; Spondylitis* ; Transplants ; Tuberculosis

BACKGROUND: The facilitatory effect of spinal prostaglandins (PGs) on nociceptive transmission suggests that early PG synthesis after nerve injury could be important in the development of allodynia. METHODS: The aim of this study is to examine the effects of diclofenac (nonselective COX inhibitor), SC-560 (selective COX-1 inhibitor), and NS-398 (selective COX-2 inhibitor) on mechanical allodynia and thermal hyperalgesia in the neuropathic pain model. The rats underwent right L5 spinal nerve ligation (SNL) and were assigned to three COX inhibitor groups to be injected intraperitoneally with different administration dosages (0.2 mg, 1 mg, 5 mg) 30 minutes before, and at 1, 2, and 3 days after SNL. The withdrawal threshold of both hindpaws in response to mechanical stimulation was measured by dynamic plantar anesthesiometer and the withdrawal ratio of right to left hindpaw was calculated. The thermal stimulation applied to both hindpaws by the plantar test was calculated different administration dosages were compared with the vehicle group. RESULTS: There were no differences in mechanical allodynia among the lower dosage groups (0.2 mg) until 14 days after SNL. However, 1 mg of NS-398 decreased mechanical allodynia compared with the vehicle group at 14 days after SNL, and 5 mg of NS-398 decreased mechanical allodynia at 3 days after SNL. However, there was no difference in thermal hyperalgesia between the groups. CONCLUSIONS: These results suggest that intraperitoneal administration of COX inhibitor (especially selective COX-2 inhibitor) after nerve ligation injury can attenuate the development of mechanical allodynia.
Animals ; Cyclooxygenase Inhibitors* ; Diclofenac ; Hyperalgesia ; Ligation* ; Neuralgia* ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Rats* ; Spinal Nerves*

Mucoepidermoid carcinoma was initially recognized as occurring only in the salivary gland and only later was it appreciated that it occurred in the bronchus and trachea as well. Mucoepidermoid carcinoma of bronchial gland origin is extremely rare, and little is known about their natural history. This carcinoma is derived from the minor salivary gland of the proximal tracheobronchial tree and it is divided into low-grade and high-grade by gross, histologic, and ultrastructural criteria. Also Its clinical and biologic behaviors are closely related with histologic grade of carcinoma. We have experienced a rare case of bronchial mucoepidermoid carcinoma associated with adenocarinoma which obstructed the left main bronchus and was successfully removed by the pneumonectomy.
Adenocarcinoma ; Bronchi ; Carcinoma, Mucoepidermoid* ; Lung ; Natural History ; Pneumonectomy ; Salivary Glands ; Salivary Glands, Minor ; Trachea ; Trees

BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
Anti-Bacterial Agents ; beta-Lactamases* ; Drug Resistance, Multiple* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units* ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Sepsis* ; Urinary Tract ; Urinary Tract Infections